5 - Mental Disorders and Consciousness

Mental disorder

a set of behavioral/psychological symptoms that are NOT in keeping with social norms, and are severe enough to cause significant personal distress/impairment to social, occupational, or personal functioning

Biomedical approach

focuses on biology - psychological illnesses ALWAYS caused by biological factors (genetics)

Biopsychosocial approach

when someone has a mental disorder, there are multiple different causes that attribute to their mental disorder

genetic predisposition, chemical imbalances, brain anatomy, traumatic brain injury

what are the traits indicating biological factors?

outside external influences that affect someone to develop a mental disorder

what are the traits indicating sociocultural factors?

sociocultural factors

peer influences, socioeconomic status, social norms/expectation, exposure to toxins in environment. is this an example of biological/sociocultural/psychological factors?

cognitive beliefs and internal reaction to stress (the external factor in the environment)

what are the traits indicating psychological factors?

psychological factors

learned helplessness, traumatic events and the reaction to trauma, negative thoughts, low self-esteem. is this an example of biological/sociocultural/psychological factors?

the disordered behavior is...
1. unusual
2. maladaptive
3. characterized by perceptual/cognitive dysfunction
4. labeled as abnormal by the society in which it occurs

what are the four criteria of a mental disorder?

1. anxiety disorders
2. depressive disorders
3. bipolar disorder
4. mood disorder/schizophrenia
5. trauma related disorders
6. personality disorder
7. obsessive compulsive disorders
8. somatic symptom disorder
9. dissociative disorders

which are the conditions of class I mental disorders?

Anxiety disorders

excessive fear and/or anxiety and in constant fight-or-flight mode. constant fear response / sympathetic activation WITHOUT the threat of stimulus

Phobias

a very SPECIFIC fear (include situational, natural environment, blood/injection/injury, and animal)

Panic disorder

include panic attacks in response to a specific trigger/generalized, but fear of possible danger is a possibility

Social anxiety disorder

fear/anxiety around social situation

Generalized anxiety disorder

excessive anxiety w/o specific cause

1. phobias
2. panic disorder
3. social anxiety disorder
4. generalized anxiety disorder

what are the FOUR types of specific anxiety disorders?

extreme dissatisfaction with self-esteem, self-devaluation and feelings of worthlessness, extreme suicidal thoughts, volatility and frequent irritability, frequent bad dreams and extreme anxiety

S/S of depressive disorders

Drugs (SSRIs/MAOIs)

what are used as treatments for depressive disorders

S/S of bipolar disorder

frequent emotional breakdowns, brief high-nrg euphoric periods, difficult to get out of bed some days, periodic intense melancholy. Involve episodes and oscillations (cycles) b/w manic phase and depressed phase

mod disorder/schizophrenia S/S

Delusions, hallucinations, disorganized speech and thoughts, may involve general detachment from objective reality

Positive symptoms of mood disorder

psychotic behaviors NOT seen in healthy people

positive symptoms of mood disorder/schizophrenia

hallucinations, delusions, disorganized speech/behavior are an example of _______________ symptoms of _____________________

Negative symptoms of mood disorder/schizophrenia

disruptions to normal emotions and behaviors, ABSENCE of normal patterns

Negative symptoms of mood disorder/schizophrenia

avolition (loss of motivation), flattened affect, reduced speech and/or interactions are an example of _______________ symptoms of _____________________

Cognitive symptoms of mood disorder/schizophrenia

thought patterns that make it hard to lead a normal life and cause emotional distress

Cognitive symptoms of mood disorder/schizophrenia

poor executive functioning, trouble focusing or paying attn, problems with working memory are an example of _______________ symptoms of _____________________

Personality disorder

enduring (often lifetime) patterns of inflexible behaviors across a range of settings and relationships (diagnosis begins in adolescence/early childhood)

PTSD

Exposure to traumatic / stressful event that lead the PT to exhibit any of a wide range of symptoms

1. genetic causes (1st degree relative have 10% chance of developing schizophrenia)
2. environmental causes (elevated cortisol levels in childhood at upon the genetic disposition of the disorder)
3. brain biology causes (enlarged brain ventricles, hippocampus abnormalities, amygdala abnormality)

what are the three causes for schizophrenia/mood disorder?

1. paranoia PD
2. schizoid PD
3. schizotypal PD

what are the conditions in cluster A of personality disorders?

1. antisocial PD
2. borderline PD
3. histrionic PD
4. narcissistic PD

what are the conditions in cluster B of personality disorders?

1. avoidant PD
2. dependent PD
3. obsessive compulsive PD

what are the conditions in cluster C of personality disorders?

cluster A personality disorders

(odd/eccentric) think of these as MILDER VERSION OF SCHIZOPHRENIA (WEIRD)

Paranoid PD

disorder that manifests the paranoid tendencies

Schizoid PD

disorder that manifests the social withdrawal and flattened affect (S/S as aloof, blunted, isolated, disengaged, and distant)

Schizotypal PD

disorder that manifests odd behavior and distorted thinking and perception (does NOT have hallucinations/delusions)

Cluster B personality disorders

(dramatic/erratic) think of these as over-the-top or unstable (WILD)

Antisocial PD

sociopathy, with no regard for right/wrong or others' rights

Borderline PD

severe abandonment anxiety and emotional turbulence in the relationship with others

Histrionic PD

over-dramatic attention seeking and emotional over-reaction

Narcissistic PD

inflated sense of self and lack of empathy

Cluster C personality disorders

(anxious/fearful) think of these as anxiety / OCD related (WORRIED)

Weird (cluster A), Wild (cluster B), Worried (cluster C)

what are the 3 Ws to remember the clusters of personality disorders?

obsessive compulsive disorders

Obsessions (thoughts/urges) and/or compulsions (repetitive behaviors). Can involve different thoughts/compulsions, based on specific thing that the individual is obsessed with

Somatic symptom disorder

excessive and/or medically unexplainable symptoms. Characterized by exaggerated fear of illness and irrational worrying about one's health (common in primary care)

dissociative disorders

Abnormal integration of consciousness, identity, emotion, etc. Disruptions and/or discontinuities in core identity. individuals feel that they perceive themselves from outside of their body

1. neurodevelopmental (autism and ADHD)
2. neurocognitive (alzheimer's, parkinson's)
3. sleep-wake disorders

what are the conditions in class II mental disorders?

1. autism spectrum disorder (ASD)
2. attention deficit/hyperactivity disorder (ADHD)

what are the conditions included in neurodevelopmental disorders? (class II)

1. early onset, usually before grade school
2. appear as deficits, generally difficult to treat
3. characterized by intellectual disability, communication disorders

what are some characteristics of neurodevelopmental disorders (Class II)

1. Impaired social interaction, avoiding eye contact with other ppl, difficulty interpreting what others are thinking or feeling, may lack empathy
2. Repetitive movements such as rocking and twirling, or self-abusive behavior such as biting or head-banging
3. Inability to play interactively with other kids

Autism spectrum disorder

1. unknown causes and affect 2-4% of school-aged children
2. Motor restlessness, difficulty paying attn, distractibility, impulsivity
3. Problem with school and work

Attention deficit/hyperactivity disorder (ADHD)

because researcher has not been able to establish a difference in the brain of ADHD children and non-ADHD children

why is ADHD diagnosis controversial?

1. Alzheimer's disease
2. Parkinson's disease

what are the conditions included in neurocognitive disorders? (class II)

Neurocognitive disorders

cognitive decline from a previous lvl of performance in complex attention, executive function, learning, memory, language, perceptual-motor, or social cognition

Alzheimer's disease

disorder in which there are abnormal protein fragments that appear throughout the brain that lead to destruction + death of nerve cells → memory failure, personality changes, problems carrying out daily activities

Parkinson's disease

primarily caused by abnormally low dopamine levels (Dopaminergic neurons in the substantia nigra of the basal ganglia DIE OFF → harder to control movements)

Amyloid plaques

clumps of protein fragments that accumulate outside of cells that's abnormal in Alzheimer's

Neurofibrillary tangles

clumps of altered proteins inside cells that's abnormal in Alzheimer's

Amyloid plaques & neurofibrillary tangles

what are the abnormal structures in the brain associated w/ Alzheimer's?

dopamine lvls progressively drop so symptoms became gradually more severe

why is Parkinson's considered as a progressive disease?

Dyssomnias

abnormalities in amount of quality/timing of sleep

Sleep-wake disorders

disturbance in quality, timing, and/or amount of sleep

Insomnia

inability to fall/remain asleep

Narcolepsy

periodic, overwhelming sleepiness during waking periods

Sleep apnea

intermittent cessation of breathing during sleep → repeated awakenings

Parasomnias

abnormal behaviors that occur during sleep

Somnambulism

sleep walking

1. tends to occur during slow wave sleep
2. happens in 1st third of the night
3. many kids experience it and eventually 'grow out of it'

Night terrors

which sleep-wake disorder occur during deep sleep?

Night terrors

appearing terrified, babbling, screaming, while deep asleep (Usually occur during stage 3 (unlike nightmares, which occur during REM))

1. sleep-wake disorders
2. insomnia
3. narcolepsy
4. sleep apnea

what are the conditions included in dyssomnias?

1. somnambulism
2. night terrors

what are the conditions included in parasomnias?

Depressants

depresses CNS (especially fight or flight reflex) → impaired motor control and organ failure from overdose

Stimulants

increases availability and action of neurotransmitters → sympathetic activation → "high" followed by crash

Hallucinogens

distorts perceptions and causes hallucinations, impaired judgment, slowed reaction time

Dependence

develops when a person neesd to use a drug in order to function normally

Tolerance

occurs when individual must use MORE of a drug to achieve the desired effect

Withdrawal

describes the group of S/S that occur when a person who has formed a dependence to a drug suddenly discontinues/decreases use of that drug (they're drug-specific and dose-dependent)

Addiction

compulsive drug use despite harmful consequence, and inability to stop using a drug

dependence, tolerance, withdrawal, addiction

what can drug use lead to?

depressants

alcohol, barbiturates, opiates are examples of what?

stimulants

caffeine, nicotine, amphetamines, cocaine are examples of what?

hallucinogens

LSD, marijuana, (THC) are examples of what?

Consciousness

the awareness that we have of ourselves, our internal states, and the environment

Reticular activating system (RAS)

controls the alertness and arousal lvl

1. sleep
2. alertness (awake)

what are the states of consciousness?

with an EEG

how are brain wave patterns measured?

1. alpha wave (8 - 12 Hz)
2. beta wave (12.5 - 30 Hz)
3. theta wave (3-7 Hz)
4. delta wave (0.5 - 3 Hz)

what are the different brain wave patterns?

Alpha wave (8-12 Hz)

brain wave associated w/ relaxed normal consciousness

Beta wave (12.5 - 30 Hz)

brain wave that's in more alert consciousness

Theta wave (3 - 7 Hz)

brain wave that's seen in young children, meditative states, and stage 1 sleep

Delta wave (0.5 - 3 Hz)

brain wave that occurs during slow wave sleep

increases, direct

As alertness INCREASES, frequency ____________ (increase/decrease), and vice versa (__________ relationship) (direct/indirect)

Circadian rhythms

control the increases and decreases in our alertness in predictable ways over a 24-hr cycle

1. melatonin (pineal gland release)
2. body temperature
3. serum cortisol levels (glucose metabolization)

what are the 3 physiological indicators of a mammal's circadian rhythm?

pineal gland

where is melatonin released from?

Suprachiasmatic nucleus (SCN) (masterclock)

brain structure that regulate sleep, melatonin production by pineal gland, and body temp. also has a hand in the daily pattern of cortisol production by the adrenal cortex

NREM1 (theta waves)

slow rolling eye movements, moderate activity, have fleeting thoughts, non-REM sleep

NREM2 (sleep spindle and K complex)

no eye movement, increased relaxation, decreased temperature, HR, and RR

NREM3 (delta waves)

no eye movement, heart and digestion slow, growth hormones secreted, deepest lvl of sleep

REM sleep

bursts of quick eye movements, almost no activity in EMG (paradoxical sleep), this is when dreams occur